Bill Text: TX HB522 | 2013-2014 | 83rd Legislature | Introduced


Bill Title: Relating to direct payment by a health insurer to physicians and health care providers.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2013-03-19 - Left pending in committee [HB522 Detail]

Download: Texas-2013-HB522-Introduced.html
  83R984 KKR-D
 
  By: Kuempel H.B. No. 522
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to direct payment by a health insurer to physicians and
  health care providers.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  The heading to Subchapter B, Chapter 1204,
  Insurance Code, is amended to read as follows:
  SUBCHAPTER B. ASSIGNMENT OF BENEFIT PAYMENTS; DIRECT PAYMENT OF
  BENEFITS
         SECTION 2.  Section 1204.051(3), Insurance Code, is amended
  to read as follows:
               (3)  "Health care provider" means a person who provides
  health care services or ambulance services under a license,
  certificate, registration, or other similar evidence of regulation
  issued by this or another state of the United States.
         SECTION 3.  Subchapter B, Chapter 1204, Insurance Code, is
  amended by adding Sections 1204.056, 1204.057, and 1204.058 to read
  as follows:
         Sec. 1204.056.  ASSIGNMENT OF BENEFITS OPTION REQUIRED.
  (a)  A health insurance policy claim form must provide an option
  for the claimant to assign benefits to a physician or health care
  provider who provided covered services.
         (b)  The health insurer may require a written attestation of
  assignment of benefits.
         Sec. 1204.057.  AMOUNT OF PAYMENT UNDER ASSIGNMENT OF
  BENEFITS. A payment to a physician or health care provider under an
  assignment of benefits may not be more than the amount the insurer
  would have paid in the absence of an assignment of benefits.
         Sec. 1204.058.  DIRECT PAYMENT PROVISION AUTHORIZED. A
  health insurance policy may provide for payment of benefits
  directly to a physician or health care provider who provides
  covered services to a covered person, even in the absence of an
  assignment of benefits.
         SECTION 4.  Subchapter B, Chapter 1301, Insurance Code, is
  amended by adding Section 1301.0561 to read as follows:
         Sec. 1301.0561.  DIRECT PAYMENT TO PREFERRED PROVIDERS
  REQUIRED. An insurer that issues a preferred provider benefit plan
  shall pay a preferred provider directly for covered services
  provided to a person insured under the plan, in accordance with this
  chapter, without requiring an assignment of benefits.
         SECTION 5.  The changes in law made by this Act apply only to
  an insurance policy delivered, issued for delivery, or renewed on
  or after January 1, 2014. An insurance policy delivered, issued for
  delivery, or renewed before January 1, 2014, is governed by the law
  in effect immediately before the effective date of this Act, and
  that law is continued in effect for that purpose.
         SECTION 6.  This Act takes effect September 1, 2013.
feedback